VS 4-108C Epidemoiolgy Report - Area Herds

See Notice/Instructions on reverse.
U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES

EPIDEMOIOLGY REPORT - AREA HERDS

OMB Approved 0579-0047
2. DOCUMENT NUMBER

See reverse for OMB Statement.
1. NAME OF HERD OWNER

INSTRUCTIONS: Outline premises of infected
herd. Using diagram below, show location of all
adjacent herds. Number each herd on diagram
and complete items A through G for each herd.
Show roads, rivers, etc., where applicable on
diagram. If there are more than 6 adjacent herds,
use additional sheets.

SUPPLEMENTAL TO VS FORM 4-108
6. DIAGRAM SHOWING LOCATION OF INFECTED AND OTHER HERDS IN SAME
LOCALITY (Define Scale Used)

3. COUNTY

4. HERD NO.

5.
PAGE

OF

A. Herd No.

B. Name and Address of Herd Owner

C. Date to be
tested.

Explain (if no test required)

D. Date
Contacted

E. Describe proximity to infected herd

F. No. Cattle

G. Co-mingling
Yes

A. Herd No.

B. Name and Address of Herd Owner

C. Date to be
tested.

Explain (if no test required)

D. Date
Contacted

E. Describe proximity to infected herd

F. No. Cattle

G. Co-mingling
Yes

N

PAGES

Explain

No

W

E

Explain

No
A. Herd No.

B. Name and Address of Herd Owner

C. Date to be
tested.

Explain (if no test required)

D. Date
Contacted

E. Describe proximity to infected herd

F. No. Cattle

G. Co-mingling
Yes

A. Herd No.

B. Name and Address of Herd Owner

C. Date to be
tested.

Explain (if no test required)

D. Date
Contacted

E. Describe proximity to infected herd

F. No. Cattle

G. Co-mingling
Yes

A. Herd No.

B. Name and Address of Herd Owner

C. Date to be
tested.

Explain (if no test required)

D. Date
Contacted

E. Describe proximity to infected herd

F. No. Cattle

G. Co-mingling
Yes

A. Herd No.

B. Name and Address of Herd Owner

C. Date to be
tested.

Explain (if no test required)

D. Date
Contacted

E. Describe proximity to infected herd

F. No. Cattle

G. Co-mingling
Yes

Explain

No

S
7. REMARKS: (Include additional herds that should be tested because of contact with or
physical location to infected herd).

Explain

No

Explain

No

Explain

No
8. In my opinion a
limited area test
is needed
Yes

VS FORM 4-108C
APR 2009

“Enter Code” (see reverse, item 8)
No

Previous edition may be used.

9. Assistance needed to
get any of the above
herds tested
Yes
No

10. Signature of VMO

CODE

11. DATE SIGNED

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0047. The time
required to complete this information collection is estimated to average 4 hours per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

NOTICE TO HERD OWNERS
Herd Owners (Managers or Agents) of herds of brucellosis affected livestock must be advised that
information is given voluntarily to assist in the elimination of brucellosis from the livestock population.
Cooperation of all affected herd owners (Managers or Agents) is needed to complete a thorough
epidemiological investigation to identify the source of the disease, the method of spread, and the
possible dissemination to new herds. The authorities under which the brucellosis program is
conducted are contained in 21 U.S.C. 111, 112, 114, 114a, 114a-1, 115, 120, 121, 125, and 1134a-f
and Title 9, Code of Federal Regulations, Parts 51 and 78.

INSTRUCTIONS
The purpose of this form is to demonstrate the geographic location of neighborhood herds in relation
to the reactor herd. The six nearest herds should be listed as a minimum. In areas of concentrated
cattle population, poor fences, open range, community pastures, high scavenger wildlife population,
etc., many more may be listed. It may be necessary to make different listing for different seasons.
The end result should be an epidemiologically sound determination of which herds should be tested.

G.

1-4. From VS Form 4-108. Item 2 is the preprinted number on the
4-108.
5.

Indicate the number of each page and the total number of pages
used.

6.

Diagram the location of the herds. The infected herd should be
lettered “A” and be at or near the center. Other herds in the
neighborhood belonging to the same owner should be labeled “B,”
“C,” etc., corresponding to VS Form 4-108, item 11 (if herds).
Separate units of the same herd should be identified as A-1, A-2,
etc., and neighborhood herds owned by others should be labeled
“1”, “2”, “3”, etc., corresponding to VS Form 4-108, item 29.
Additional herds (as many as necessary) should be consecutively
numbered (7, 8, and so forth) on a separate form. The diagram
should be somewhat to scale and the scale indicated. Each herd
should be listed on the left and the following information provided:

Indicate if there has been any commingling with the
reactor herd and explain to what extent and when. As
many sheets of VS Form 4-108C may be used as
necessary to list all herds. A plat map, country road
map, geographic survey map, etc., may be attached to
better demonstrate the relationships between different
herds, pastures, etc.

7.

Self-explanatory

8.

This calls for your evaluation of whether more extensive testing is
needed to eradicate brucellosis from the area. This is generally
determined by the number of infected herds occurring in the area.
Use the following letter codes to describe your evaluation:
A.

Ring of 1 negative herds around the infected herd.

B.

Ring of 2 negative herds around the infected herd.

C.

Radius of 1 mile around the infected herd.

A.

Record the number corresponding to the location on the
diagram.

B.

Record the complete legal name and address.

D.

Radius of 2 miles around the infected herd.

C.

Record the date tested or scheduled for test. If you do not
plan to test the herds, give justification.

E.

Test of adjacent herds only.

D.

Record the date the herd owner was contacted.

F.

Other zone testing (specify).

E.

Record the distance the cattle of this herd are from cattle in
the infected herd at the closest point.

G.

None – Give reasons in remarks.

F.

Record the total number of test eligible cattle in the herd.

VS FORM 4-108C (Reverse)

9-11.

Self-explanatory.

Privacy Act Notice
Veterinary Services – Brucellosis Information System and Brucellosis Recording and Reporting System
Authority: 21 U.S.C. 111, 112, 114, 114a-1, 115, 120, 121, 125, 134a-134f and title 9, Code of Federal Regulations, part 51 and
part 78.
Purpose and Routine Uses:
Routine uses of records maintained in the system, including categories of users and the purposes of such uses:
1)
2)
3)
4)
5)
6)
7)

Detecting the foci of infection to reduce the rate of spread of infection to new herds;
Evaluating brucellosis program activities of State, Federal, and contractual personnel;
Preparing mailing labels and preaddressed forms to enhance field activities;
Evaluating program effectiveness;
Detecting factors of epidemiologic importance in containing or eliminating foci of infected herds;
Assuring that brucellosis indemnities are promptly and properly paid;
Notification of livestock owners with the animals at high risk of exposure to brucellosis because of livestock movements or
an outbreak of disease or presence of quarantined premises in a community;
8) Referral to the appropriate agency, whether Federal, State, local, or foreign, charged with responsibility of investigating or
prosecuting a violation of law concerning animal disease control and eradication, or of enforcing or implementing a
statute, rule, regulation, or order issued pursuant thereto, of any record within this system when information available
indicates a violation or potential violation of law concerning animal disease control and eradication, whether civil, criminal,
or regulatory in nature, and either arising by general statute or particular program statute, or by rule, regulation, or court
order issued pursuant thereto;
9) Litigation by the Department of Justice when the agency, or any component thereof, or any employee of the agency in his
or her official capacity, or any employee of the agency in his or her individual capacity where the Department of Justice
has agreed to represent the employee, or the United States, where the agency determines that litigation is likely to affect
the agency or any of its components, is a party to litigation or has an interest in such litigation, and the use of such
records by the Department of Justice is deemed by the agency to be relevant and necessary to the litigation; provided,
however, that in each case, the agency determines that disclosure of the records to the Department of Justice is a use of
the information contained in the records that is compatible with the purpose for which the records were collected;
10) Use in a proceeding before a court or adjudicative body before which the agency is authorized to appear, when the
agency, or any component thereof, or any employee of the agency in his or her official capacity, or any employee of the
agency in his or her individual capacity where the agency has agreed to represent the employee, or the United States,
where the agency determines that litigation is likely to affect the agency or any of its components, is a party to litigation
or has an interest in such litigation, and the agency determines that use of such records is relevant and necessary to the
litigation; provided, however, that in each case, the agency determines that disclosure of the records to the court is a use
of the information contained in the records that is compatible with the purpose for which the records were collected; and
11) Response to a request from a congressional office from the record of an individual made at the request of that individual.
To certain Federal and State animal health officials to conduct, analyze, and report on the progress of animal disease
control or surveillance programs.

Disclosure: Furnishing this information is voluntary; however, failure to furnish this information may impede brucellosis
eradication activities.

COPY DESIGNATIONS
PART 1 – HERD FILE
PART 2 – CATTLE DISEASES STAFF
RIVERDALE, MD (Free Areas only.)
PART 3 – STATION EPIDEMIOLOGIST
PART 4 – STATE OR FEDERAL FIELD
VETERINARIAN